A probe into the effects of attending a community-based weight management program on weight loss, lipid profile, and blood pressure in long-term cardiac transplant recipients. Cardiac transplantation is an accepted treatment for selected patients with end-stage heart failure. Following transplantation, chronic problems related to maintaining the prevention of the immune response, which is required following cardiac transplantation, effect a significant percentage of transplant recipients. These problems include obesity, high blood pressure, high cholesterol count, kidney problems or failure, diabetes mellitus, and malignancies. Also, at least 50% of the patients have evidence of organ rejection five years after transplantation, a condition which is associated with a mortality rate of more than 40% during the two years after diagnosis. This study will involve approximately 40 people who have had cardiac transplantation. The study is of the influences of two weight management interventions for long-term cardiac transplant recipients. The comparison of effects of a community-based weight management program to a clinic- based weight management education on weight loss, cholesterol levels, blood pressure, overall health, life style, and quality of life will be studied. Involvement in the study will be for six months with 20 minute visits. A questionnaire about life style, weight loss barriers, health management, and quality of life will be completed. Blood pressure, height, weight, and cholesterol levels will be measured. Assignments to each of the types of weight management groups will be randomly decided. Clinic-based subjects will receive an appointment for a consultation visit at the General Clinical Research Center. The community-based subjects will follow the Weight Watchers 1-2-3 Success Program for 26 weeks. Patient charts will be reviewed by a research assistant to obtain information about health and medications taken by the subjects. Patients in the community-based program will have the number of attended meetings examined and food and exercise diaries for choices and exercise.
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